Image by Pixabay
As Professor Sam Savage said in a lecture on risk management; “We must connect the seat of our learning with the seat of our pants”.
Trying to manage a killer pandemic by staring at a graph, or “following the science” as inferred by the latter, simply can’t and won’t work as indeed we have seen.
Dhaluza at English Wikipedia, CC BY-SA 3.0 , via Wikimedia Commons
Here is a simple calculation taken from flying a glider. Old men and boys alike fly these things in the US and Australia to dust crops and it’s done naturally via the limbic system just like riding a bike.
In the cockpit there’s a very simple dial that shows your angle to the ground, when this reaches a certain level you are in trouble, but when you haul back on the stick, nothing happens and very shortly you become unconscious as your craft hits terra ferma, Why?
Time from reaching dangerous angle to seeing it on the graph =2 seconds.
Time from seeing on the graph to collision =1 second.
That’s 3 seconds.
Time needed to correct the angle =4 seconds. Tough luck.
Looking out the window at the horizon and focusing on the seat of your pants, you get a whole 7 seconds of warning. That’s 3 seconds to spare for thinking and reacting.
Give a good cyclist a similar dial for the angle of his bike and he’ll end up dirty and bloody, it’s a safe bet.
Let’s look at something a bit livelier than an economy which has long and short credit cycles and other stuff hiding the cause and effect. Covid 19 pandemic in UK is a great case study.
Back in September 2019, the Chinese province of Wuhan saw an outbreak of Virus resulting in Covid 19. They approached it like WW3. Keeping careful records, testing everyone, cleansing even outdoor public areas and with ruthless efficiency, they got rid of the problem in just a few weeks. China went on to enjoy an economic boom in 2020 selling goods to Americans with stimulus cheques to spend, so much so that shipping has been at full capacity for many months globally as they all haul-ass to the US. All against the backdrop of Trump’s “Chinavirus”.
The cost to China was a little over a month of discomfort and lost GDP more than made up for later in the year.
That was pure seat-of-the-pants stuff relying on what we all know to be universal about viral epidemics and what they could learn quickly.
They then passed all their acquired knowledge to UK and Italy where the pandemic was now raging. Italy provided UK with further vital information to prepare for the battle ahead.
Here, in essence, is how the UK tackled Corona virus.
They built a lovely graph probably in excel where you could enter the death figures for today in one column and in the other column the deaths multiplied by 102 would appear. This calculation was arrived at by looking at the data provided by Wuhan and working out their ratio between deaths and illnesses two weeks ago in order to guess how many probably were ill in UK.
You may be wondering, why infections rather than deaths? Well, that one is simple, the goal of this fight was not to save lives, or even to get rid of the pandemic from UK shores, but simply to ensure that the NHS did not run beyond capacity and hence over budget.
From that moment onwards, the pilot sat staring at his graph and basing his decisions on the numbers of infections out there according to his graph.
It would be careless of me not to mention that along the way, they decided against declaring all deaths because it made them look bad, especially the ones left to die in nursing homes, so they adopted the policy that only deaths where the person had tested positive in the past few weeks would be counted. Did they adjust the ratio? What is your guess?
Before you storm off in horror, also factor in the fact that not until late Spring was there widespread testing available in UK and before that time, a great many deaths from Covid involved people who had never been tested and indeed many who had not even gone to hospital. There were ethnic groups in Birmingham who, when interviewed, made it clear that for reasons I’m not clear on, they would die at home rather than trust a hospital.
To see for yourself the difference this made you need only look up the numbers of deaths in 2020 compared to the average over the previous five years and that difference is much closer to the true cost of Covid 19 in terms of people lives.
These were real people with children or parents, friends and lovers, people whose lives mattered and quite a few were gallant health care workers who died in the line of fire, many without adequate protection.
All these things on top of the foolishness of looking at graphs even when full of accurate data, made a group of fools look even more foolish.
To suggest that there was anything at all scientific about this performance is an insult to every scientist on the planet.
The Wuhan recipe as followed by Taiwan and later New Zealand, Australia and others is simplicity itself. Lockdown and stop all cross-infection opportunities. Shut borders and stop anyone bringing it in. Test exhaustively to catch infection early and then track all recent contacts of everyone who tests positive making them isolate. Anybody’s grandmother could have written that strategy without putting down the knitting.
All that’s required is call centres in each area receiving the lists of phone numbers, calling them and recording their work. The new apps offered by Google/Apple made that easier by sending out such warnings automatically to phones that come close to that of an infected person, but that’s a bonus not a necessity.
Here’s what the UK did about track and Trace.
They spent the price of a small country on a Track and trace system that had to be abandoned because it didn’t work when put under trial in the field.
They then spent the price of another small country on a smaller system that as far as we know has completely flopped. All the time, they pursued what appears to be grandiose centralised systems when all they needed was simple local systems that they expressly refused to engage with despite these being proven around the globe.
They then gave access to the private health records of UK citizens, without asking for or receiving permission to so do, to a renowned blackguard called Palantir a military contractor who are based in the US and have a reputation for using such data to encourage biased policing and various shady operations within war zones. Many I have spoken to are connecting the engagement with Palantir and the grandiose centralised systems as evidence of an ulterior agenda. It does seem a tempting hypothesis and it has no basis in fighting Corona Virus, none whatsoever.
How? Why? When? Where the hell did they get the idea that this was OK let alone any sort of indication that doing this might in some way contribute to dealing with Covid 19. What the hell were they thinking of?
“The government had license to act fast because it was dealing with a pandemic, but we didn’t give them permission to act fast and loose with public money,” said Meg Hillier, a lawmaker with the opposition Labour Party and chair of the powerful Public Accounts Committee. “We’re talking billions of pounds, and it’s quite right that we ask questions about how that money was spent.”
Quoted in NYT
The PPE shambles
Towards the end of March, Paul (Lord) Deighton, was appointed as the czar for PPE ( the stuff, the scarcity of which had led to so many Health workers dying) and he certainly got in the spirit of things awarding billions of pound worth of contracts . He also made numerous lucrative awards to companies where he had financial interests or connections. So far, from what I can find, £22 billion worth of this spending has been made public, but according to the National Audit Office as much as half of that went to companies with no experience nor other reason to assume they might be capable of delivering. Some did, many did not as far as we can access the results of those procurements. About £5billion went to companies with ex ministers and government advisers on the staff or connected and a similar number went to known tax evaders or Human rights abusers.
Lets be clear about this, I’m not suggesting that government officials were engaged in illegal behaviour simply that this was a shocking failure in procedure, due diligence and basic management but it’s hard not see evidence of cronyism. Its also hard to turn a blind eye to billions of pounds being awarded to companies with share capital of a pound or two and poor credit ratings. There’s really no good explanation, nor excuse and it’s hard to accept that any attempt could have been made at due diligence, even taking into account a rookie crew, a blind panic and a few terrible errors of judgement.
The whole PPE fiasco could itself be put down to ill advised outsourcing deals since the stockpile of PPE held for just such a pandemic became unobtainable to the UK team towards the beginning of April as a result of legal disputes and bankruptcy involving the outsourced US based supplier and their UK landlord. This dispute resulted in an RAF plane rushing to Turkey to collect stop gap supplies while their stockpile issue was being resolved.
Its tempting to get bogged down in the errors and the cronyism, but I set out to write about the difference between management and fake science.
How the data could have been used a little better.
What we need on our graph is not just the fake data for deaths and infections, but also accurate data for capacity at our hospitals around the country.
With that in place, we need one more ratio the one between today’s infections and the demand for hospital beds in 10–14 days time.
That’s a help. But there’s still the problem of wait time. Its no good telling me the boat will sink when I’m wet up to my knees, I need a little thinking time.
When your data is already guess-work, it may seem crass to add more guesses, but given you have nothing better, if you build enough slack into these guesses and work back with caution towards reality, its surprising how quickly you can learn the real figures.
To do this we can use a simple tool available in Excel and all good schoolboy tools, no need for any scientists to create a simple linear regression.
What a regression does is to examine all the data you already added in a column and ask itself, if we continue adding data over time and we follow the same trend, what will the line look like in a day, a week, a month. You choose the periods and now you get to see what is possibly waiting for you down the road. You can also adjust this based on whether you are feeling confident, or expecting the worst.
The second thing you need is to apply your ratio to this projected line so that projects the demand on your healthcare capacity, or in this case beds.
The third thing is to add a little scenario building so that you can ask the questions what will happen to healthcare capacity if infections increase by n%? This can be done with a simple slider that lets you choose the likely variance.
Very quickly you pinpoint where Armageddon lives and how far away, but for the grace of Boris Johnson you are right now. A sobering but altogether vital view and basic schoolboy stuff requiring not a single scientist.
Of course, if you were determined to look clever, you could use Monte Carlo analysis to predict all the possible outcomes and see where your safe zone is. You could have all kinds of fun, but that’s the whole point, it’s not meant to be fun, it should scare the trousers off you.
Back to grandma, back to Wuhan.
Grandma never used excel let alone claimed to be a data scientist, yet most of us have a grandma who would have done an immensely better job than Boris Johnson and Matt Hancock at saving a few lives and getting rid of Covid.
Its easy for someone like me to get all sanctimonious and say, look you had a rehearsal for this not long ago and you were very well prepared for a pandemic, you shouldn’t have let it slip. Or why did you let control of the emergency stockpile slip, or why did you wait so long to order more PPE, or why did you scorn European offers of help? The truth is that anyone can make mistakes in a new job in the middle of an emergency. As long as you have the right goal at heart and are prepared to learn from mistakes, you are entitled to forgiveness.
This is where my problem lies. Never at any time have I heard anything to suggest that these people care at all about lives, not even the lives of doctors and health staff who are now suing them for carelessness.
Right through the pandemic, they have been happy to sacrifice lives by sending them down the underground, into restaurants, even paying half the bill, sending innocent children into schools despite knowing the risks not just to those children but also their families. For me, having lived a sheltered life, this is the most callous attitude I have ever experienced and frankly I never expected that a European or so-called civilised democracy, would ever take such a cold and callous view of their responsibility to their own citizens, nor did I ever imagine they could do this without being hauled before some courts to answer for it.
It was never rocket science, first the Chinese and then the Italians told us how to do it. The advice has not changed at all in a year. Lock down. Test and trace, close borders, protect the more vulnerable. Others have used this advice to great effect, why not the UK?
There is evidence from early days, that the UK decided to ignore this proven advice, hardly because there was any reason to doubt it, but either because they doubted their ability to execute on it, or perhaps they didn’t see saving lives as one of their chief goals in office.
After all, the UK suffers an ageing population that is a considerable drain on the youth in a country with no Sovereign Wealth Fund for this purpose. Certainly, there are reports of a meeting in which Dominic Cummings reportedly said, “if it means some old people dying, so be it”, or words to that affect.
Certainly we have clear evidence of vast numbers of old people infected with Covid being denied hospital care, but instead sent to care-homes that not only were unable to treat or save these people, but not equipped to protect themselves. This resulted in not just many thousands of old people, but also care home staff dying of Covid 19. I have many years of experience in working with bureaucratic organisations and I understand how easily mistakes can multiply, but the key to understanding why is usually to look at the underlying strategic decisions. Good decisions often end up in bad execution, through error, but bad decisions are statements of intent.
Read about The Do feck all strategy.